Eosinophilic esophagitis (EoE) is a chronic inflammatory disorder of the esophagus that is becoming increasingly common across all age groups. The condition triggers symptoms such as difficulty swallowing, chest pain, and food impaction. Without treatment, inflammation can create scar tissue, stiffening the esophagus and leading to serious complications, including rupture.
For adults and adolescents, the primary warning signs are trouble swallowing or the sensation of food moving slowly. These symptoms are not normal and warrant immediate medical examination, especially in individuals with asthma, eczema, or food allergies. Children often present differently, showing symptoms like abdominal pain, vomiting, or failure to transition to solid textures.
Diagnosis requires an endoscopy with biopsy. During this procedure, a camera examines the esophagus for visual inflammation, white patches, or ring-like scarring. Pathologists then confirm the presence of allergic cells, known as eosinophils, to rule out other conditions. There are currently no blood tests available for EoE.
Management is a lifelong, multi-disciplinary process. There are two primary treatment categories: dietary restriction and medication. Since EoE is often triggered by food allergens-most commonly dairy, wheat, eggs, soy, nuts, and seafood-dietary elimination is a key strategy. Medical options start with anti-acid medications, which help 30% to 40% of patients. A topically acting corticosteroid, budesonide oral suspension, is specifically formulated to coat the esophagus and shows efficacy in 50% to 60% or more of cases. For refractory cases, dupilumab, a systemic injection, blocks allergic factors driving the disease.
Patients require continuous monitoring with a specialized medical team, which may include gastroenterologists, allergists, and dietitians. Researchers are rapidly advancing the science, providing more therapeutic options than were available just a few years ago.